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Updated: Nov 10, 2025
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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
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[Posture-dependent headache caused by spontaneous intracranial hypotension]
M E Belderbos1,2, G J Amelink3, J W Dankbaar4
1Universitair Medisch Centrum Utrecht, Prinses Máxima Centrum voor Kinderoncologie, Utrecht.
Nederlands Tijdschrift Voor Geneeskunde
|April 1, 2021
Summary
Spontaneous intracranial hypotension can cause severe orthostatic headaches. Prompt recognition and treatment, including epidural blood patches, lead to complete recovery and prevent serious complications.
Area of Science:
- Neurology
- Radiology
Background:
- Intracranial hypotension is a condition characterized by low cerebrospinal fluid pressure.
- It can manifest as severe orthostatic headaches, worsening when upright and improving when lying down.
Observation:
- A 36-year-old woman experienced a 3-4 month history of severe, progressive headache with postural variation.
- Brain MRI showed abnormalities consistent with intracranial hypotension, and spinal MRI revealed an extradural fluid collection.
Findings:
- The patient's symptoms were attributed to spontaneous intracranial hypotension.
- Treatment with caffeine, bed rest, and lumbar epidural blood patches resulted in complete recovery.
Implications:
- Early identification of spontaneous intracranial hypotension is crucial for timely and effective management.
- Successful treatment can prevent potentially life-threatening complications associated with this condition.
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